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The website Gizmodo ("We come from the future") recently asked a bunch of historians of technology (Aww, someone cared what historians think) what technological innovation has "accidentally" caused the most deaths.
Their answers range from the slave ship to the mechanical cigarette roller, but most of the historians respond, more or less, "Well, it's complicated." The way they do it suggests that historians always say that because it's mostly always true. The answers are longish, and hard to tally or quantify, but well worth browsing.
An excerpt from a vote for the railroad by the American scholar Blair Stein, with a Canadian example:
In Canada, the “numbered treaties” system of the 1870s extinguished Indigenous claims to the land so the state could build the Canadian Pacific Railway, laying the groundwork for 150 years of fatal structural inequalities. To some historical actors at the time, these deaths may have been “accidents,” inadvertent casualties in the name of technological progress and nation-building. They also may not have been seen as directly caused by rail, but rather an oblique consequence of it. But railroads were part of the machine of empire.Hat tip to the ever lively Lawyers, Guns, & Money